Provider Demographics
NPI:1548501943
Name:EXPRESS REHAB CARE PT,PC
Entity type:Organization
Organization Name:EXPRESS REHAB CARE PT,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT,DPT
Authorized Official - Prefix:MR
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:ELKHOULY
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT
Authorized Official - Phone:718-709-6442
Mailing Address - Street 1:372 AVENUE U
Mailing Address - Street 2:SUITE LL3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4018
Mailing Address - Country:US
Mailing Address - Phone:718-372-1690
Mailing Address - Fax:718-372-1691
Practice Address - Street 1:372 AVENUE U
Practice Address - Street 2:SUITE LL3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4018
Practice Address - Country:US
Practice Address - Phone:718-372-1690
Practice Address - Fax:718-372-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-09
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018447174400000X
NY013410174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty